| (a) During the investigation of a complaint, the Enforcement
Committee may order the outside peer review of a licensee's standard
of patient care or billing practices.
(b) To qualify as a peer reviewer, a person shall:
(1) have an active license with the Board or appropriate
professional credentials;
(2) have no prior violations of Board statutes or rules;
(3) have no open complaints;
(4) have no felony convictions or misdemeanor convictions
for a crime of moral turpitude;
(5) show sufficient training or experience to offer
an informed opinion;
(6) show knowledge of accepted standards of chiropractic
care in Texas or other professional standards related to the alleged
violation; and
(7) have an acceptable malpractice complaint history.
(c) A peer reviewer may not review a complaint if the
peer reviewer has:
(1) a direct financial interest or relationship with
any party or witness to the complaint that gives the appearance of
a conflict of interest;
(2) a familial relationship within the third degree
of affinity with any party or witness;
(3) personal knowledge of any information about any
party or witness related to the complaint; or
(4) any other reason where the peer reviewer could
not fairly and impartially consider the complaint.
(d) The Board shall maintain a list of peer reviewers
and shall periodically audit the list to confirm their qualifications.
(e) Board staff shall select a peer reviewer when an
investigator identifies a standard of care or other professional standard
beyond the expertise of staff in the complaint.
(f) Board staff shall randomly select a peer reviewer
from the list based on the peer reviewer's qualifications to review
the type of complaint.
(g) The executive director shall remove a peer reviewer
from the list for:
(1) failure to maintain the required qualifications;
(2) failure to timely complete reports;
(3) failure to inform the Board of potential or apparent
conflicts of interest; or
(4) failure to maintain the confidentiality of any
matter.
(h) The Board shall provide to the peer reviewer:
(1) the complaint;
(2) the investigator's report;
(3) the Board's peer review report form; and
(4) a contract for services.
(i) The peer reviewer shall review all relevant information
to determine if a licensee violated the applicable standard of care
in Texas or other professional standard and prepare a written report.
(j) The peer reviewer's report shall include:
(1) the peer reviewer's qualifications;
(2) the relevant facts of the complaint;
(3) the applicable standard of care or other professional
standard;
(4) an application of the standard of care in Texas
or other professional standard to the facts;
(5) a finding of whether the standard of care or other
professional standard was met; and
(6) the clinical basis for the findings, including
the use of any peer-reviewed journals, studies, or reports.
(k) A peer reviewer may not offer a legal opinion as
to whether a particular statute, Board rule, or other law was violated.
(l) A peer reviewer may not offer an opinion on the
legal liability of any individual for an injury sustained by a patient.
(m) The peer reviewer shall complete and return the
review to the Board within 30 days, unless the peer reviewer requests
more time due to the complaint's complexity.
(n) The Board shall give the peer reviewer's report
to the licensee within 30 days of receipt.
(o) The Enforcement Committee shall consider the report
and the licensee's response in determining if a violation occurred.
(p) The Enforcement Committee may order additional
peer reviews if necessary.
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